PURPOSE: The objective was to study whether positive surgical margins (PSMs) predict biochemical recurrence (BCR) in all patients without adjuvant therapy after radical prostatectomy (RP).
MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent RP for prostate cancer at Veterans Health Service Medical Center from 2005 to 2011. BCR was defined by a prostate-specific antigen (PSA) value ≥0.2 ng/mL. The clinicopathological factors of the PSM group were compared with those of the negative surgical margin (NSM) group, and the predictive impact of a PSM for BCR-free survival were evaluated. In addition, we analyzed the prognostic difference for BCR-free survival between solitary and multiple PSMs.
RESULTS: A PSM was noted in 167 patients (45.5%). BCR was reported in 101 men in total (27.5%). The BCR-free survival rate of the PSM group was lower than that of the NSM group (p< 0.001). In a multivariate analysis for the total patients, PSM was significantly associated with BCR-free survival (p< 0.001). After stratification by pathological T stage, Gleason score (GS), and preoperative PSA value, PSM was significantly predictive for BCR-free survival in men with pT2 and/or GS ≤ 6 or 7 and/or a PSA value < 10 or 10-20 ng/mL (all p< 0.05). Multiple PSMs were more predictive of BCR-free survival than was a solitary PSM (p=0.001).
CONCLUSIONS: A PSM is a significant predictor of postoperative BCR in patients with pT2 and/or GS ≤ 7 and/or preoperative PSA < 20 ng/mL. Multiple PSMs are considered a stronger prognostic factor for prediction of BCR than is a solitary PSM.
Written by:
Lee JW, Ryu JH, Kim YB, Yang SO, Lee JK, Jung TY. Are you the author?
Department of Urology, Veterans Health Service Medical Center, Seoul, Korea.
Reference: Korean J Urol. 2013 Aug;54(8):510-5.
doi: 10.4111/kju.2013.54.8.510
PubMed Abstract
PMID: 23956825
UroToday.com Prostate Cancer Section
